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INTRODUCTION ? Sickle cell anaemia is an important genetic disorder with varying impacts on pregnancy outcomes. ? While sickle cell disease (homozygous) is associated with severe maternal and perinatal complications, the effects of sickle cell trait(heterozygous) are often regarded as benign but with potential risks under stress conditions like pregnancy. AIM ? To study the Outcomes of sickle cell anaemia in pregnancy OBJECTIVES ? To analyse maternal and fetal outcomes in pregnancies with sickle cell disease and trait focusing on complications and overall prognosis. MATERIAL & METHODS ? A retrospective observational study of 100 pregnant women with sickle cell anaemia was conducted at King George hospital, a tertiary care centre in visakhapatnam over 1 year. ? The details were obtained from the hospital records and analysed statistically. RESULTS ? MATERNAL OUTCOMES ?Women with homozygous sickle cell disease (25 cases) had significantly higher rates of complications like vaso-occlusive crises(40%), severe anaemia with transfusion requirements( 64%), hypertensive disorders(25%) and maternal mortality(4%-1 case). ?Among women with sickle cell trait(75 cases), severe Anemia was observed in 13% and hypertensive disorders in 12%. ?PERINATAL OUTCOMES ?Preterm deliveries, Low birth weight,IUGR& NICU admissions are observed among homozygous sickle cell disease group in higher rates compared to trait group. CONCLUSION ?Pregnancies in women with Homozygous sickle cell disease are associated with severe complications and poor outcomes while sickle cell trait carries comparatively mild risk. ?Tailored management strategies including pre-conceptional counselling ,close monitoring and multidisciplinary care are crucial to improve outcomes in these pregnancies.